These pseudomembranous lesions and erosions of the tongue, the hard and soft palate, and tonsils are consistent with secondary syphilis.
A 26-year-old man presented with a four-month history of whitish oral lesions and pain in swallowing. The patient had noticed lesions on the glans penis seven months previously, but these had cleared spontaneously. Otherwise, he was afebrile and in good overall health. Physical examination revealed pseudomembranous lesions and erosions of the tongue, the hard and soft palate, and tonsils, as well as generalized lymph node enlargement. Condylomata lata, macular skin lesions, and alopecia were absent. Titers of Treponema pallidum were 1:81,920 on hemagglutination assay, and a fluorescent treponemal antibody absorption test was positive. A serologic test for human immunodeficiency virus infection was negative. The patient was treated with intramuscular penicillin G benzathine (2.4 million U), with full resolution of the oral lesions within two weeks.